[19]
`United States Patent
`6,132,368
`[11] Patent Number:
`Cooper *Oct. 17, 2000 [45] Date of Patent:
`
`
`
`
`
`US006132368A
`
`[54] MULTI-COMPONENT TELEPRESENCE
`SYSTEM AND METHOD
`
`[75]
`
`Inventor: Thomas G. Cooper, Menlo Park, Calif.
`
`[73] Assignee:
`
`Intuitive Surgical, Inc., Mountain
`View, Calif.
`
`[*] Notice:
`
`This patent issued on a continued pros-
`ecution application filed under 37 CFR
`1.53(d), and is subject to the twenty year
`patent
`term provisions of 35 U.S.C.
`154(a)(2).
`
`[21] Appl. No.: 08/975,617
`
`[22]
`
`Filed:
`
`Nov. 21, 1997
`
`Related US. Application Data
`Provisional application No. 60/033,321, Dec. 12, 1996.
`
`[60]
`
`Int. Cl.7 ........................................................ A61B 1/00
`[51]
`[52] US. Cl.
`................................ 600/102; 606/130; 606/1
`[58] Field of Search ..................................... 600/101, 102,
`600/114, 121, 122; 606/1, 130; 128/849—856
`
`[56]
`
`References Cited
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`.
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`.
`
`.
`
`.
`
`(List continued on next page.)
`
`FOREIGN PATENT DOCUMENTS
`
`7/1993
`WO 93/13916
`11/1994
`WO 94/26167
`6/1995
`WO 95/16396
`11/1995
`WO 95/30964
`WO 96/39944 12/1996
`
`WIPO .
`WIPO .
`WIPO .
`WIPO .
`WIPO .
`
`Primary Examiner—John P. Leubecker
`Attorney, Agent, or Firm—Townsend and Townsend and
`Crew LLP; Mark D. Barrish, Esq.
`
`[57]
`
`ABSTRACT
`
`The present invention provides systems and methods for
`performing robotically-assisted surgical procedures on a
`patient. In particular, a three-component surgical system is
`provided that
`includes a non-sterile drive and control
`component, a sterilizable end effector or surgical tool and an
`intermediate connector component that includes mechanical
`elements for coupling the surgical tool with the drive and
`control component and for transferring motion and electrical
`signals therebetween. The drive and control component is
`shielded from the sterile surgical site, the surgical tool is
`sterilizable and disposable and the intermediate connector is
`sterilizable and reusable. In this manner, the intermediate
`connector can be sterilized after a surgical procedure with-
`out damaging the motors or electrical connections within the
`drive and control component of the robotic system.
`
`41 Claims, 9 Drawing Sheets
`
`
`
`1
`
`Exhibit 1018
`Intuitive v. Ethicon
`|PR2018—01254
`
` 1
`
`Exhibit 1018
`Intuitive v. Ethicon
`IPR2018-01254
`
`

`

`6,132,368
`
`Page 2
`
`US. PATENT DOCUMENTS
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`
`11/1994
`12/1994
`3/1995
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`5/1995
`6/1995
`
`.
`
`.
`Slater et al.
`Lathrop, Jr. et al.
`Taylor .
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`Denen et al.
`.
`Taylor .
`Funda et al.
`Depp .
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`.
`
`.
`
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`5,792,135
`5,800,423
`5,855,583
`5,876,325
`
`9/1995
`4/1997
`5/1997
`7/1997
`12/1997
`8/1998
`9/1998
`1/1999
`3/1999
`
`.
`
`Jacob .
`Smith et al.
`Green .
`.
`Jensen et al.
`
`Carol et al. ....................... 606/130
`Madhani et al.
`.
`Jensen .
`
`Wang et al.
`Mizuno et al.
`
`............................ 606/130
`......................... 600/102
`
`2
`
`

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`US. Patent
`
`Oct. 17,2000
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`Sheet 1 0f9
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`6,132,368
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`6,132,368
`
`1
`MULTI-COMPONENT TELEPRESENCE
`SYSTEM AND METHOD
`
`CROSS-REFERENCE TO RELATED
`APPLICATIONS
`
`This application is a continuation of, and claims the
`benefit of priority from, US. Provisional Patent Application
`Ser. No. 60/033,321, filed Dec. 12, 1996, the full disclosure
`of which is hereby incorporated by reference.
`
`BACKGROUND OF THE INVENTION
`
`This invention relates to robotically-assisted surgical
`manipulators and more particularly to systems and methods
`for performing telerobotic surgical procedures on a patient
`while providing the surgeon with the sensation of physical
`presence at the surgical site.
`In robotically-assisted or telerobotic surgery, the surgeon
`typically operates a master controller to remotely control the
`motion of surgical instruments at the surgical site from a
`location that may be remote from the patient (e.g., across the
`operating room, in a different room or a completely different
`building from the patient). The master controller usually
`includes one or more hand input devices, such as joysticks,
`exoskeletal gloves or the like, which are coupled to the
`surgical instruments with servo motors for articulating the
`instruments at the surgical site. The servo motors are typi-
`cally part of an electromechanical device or surgical
`manipulator (“the slave”) that supports and controls the
`surgical instruments that have been introduced directly into
`an open surgical site or through trocar sleeves into a body
`cavity, such as the patient’s abdomen. During the operation,
`the surgical manipulator provides mechanical articulation
`and control of a variety of surgical instruments, such as
`tissue graspers, needle drivers, electrosurgical cautery
`probes, etc., that each perform various functions for the
`surgeon, e.g., holding or driving a needle, grasping a blood
`vessel, or dissecting, cauterizing or coagulating tissue.
`This new method of performing telerobotic surgery
`through remote manipulation has, of course, created many
`new challenges. One such challenge results from the fact
`that a portion of the electromechanical surgical manipulator
`will be in direct contact with the surgical instruments, and
`will also be positioned adjacent
`the operation site.
`Accordingly, the surgical manipulator may become contami-
`nated during surgery and is typically disposed of or sterilized
`between operations. Of course, from a cost perspective, it
`would be preferable to sterilize the device. However, the
`servo motors, sensors, encoders and electrical connections
`that are necessary to robotically control the motors typically
`cannot be sterilized using conventional methods, e.g., steam,
`heat and pressure or chemicals, because they would be
`damaged or destroyed in the sterilization process.
`Yet another challenge with telerobotic surgery systems is
`that a surgeon will typically employ a large number of
`different surgical instruments during a procedure. Since the
`number of instrument holders are limited due to space
`constraints and cost, many of these surgical instruments will
`be attached and detached from the same instrument holder a
`
`In laparoscopic
`number of times during an operation.
`procedures, for example, the number of entry ports into the
`patient’s abdomen is generally limited during the operation
`because of space constraints as well as a desire to avoid
`unnecessary incisions in the patient. Thus, a number of
`different surgical instruments will typically be introduced
`through the same trocar sleeve during the operation.
`Likewise, in open surgery, there is typically not enough
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`room around the surgical site to position more than one or
`two surgical manipulators, and so the surgeon’s assistant
`will be compelled to frequently remove instruments from the
`holder and exchange them with other surgical tools.
`What is needed, therefore, are improved telerobotic sys-
`tems and methods for remotely controlling surgical instru-
`ments at a surgical site on a patient. These systems and
`methods should be configured for easy sterilization so that
`they can be reused after the components have been contami-
`nated during an operation. In addition, these systems and
`methods should be designed to minimize instrument
`exchange time during the surgical procedure.
`SUMMARY OF THE INVENTION
`
`The present invention provides systems and methods for
`performing remote, robotically-assisted surgical procedures
`on a patient while providing the surgeon with the sensation
`of physical presence at the surgical site (i.e., telepresence).
`In particular, a three-component surgical system is provided
`that includes a non-sterile drive and control component, a
`sterilizable end effector or surgical tool and an intermediate
`connector component that includes mechanical elements for
`coupling the surgical
`tool with the drive and control
`component, and for transferring motion from the drive
`component
`to the surgical
`tool. The drive and control
`component is shielded from the sterile surgical site, the
`surgical tool is sterilizable and disposable and the interme-
`diate connector is sterilizable and reusable. In this manner,
`the intermediate connector can be sterilized after a surgical
`procedure without damaging the motors or electrical con-
`nections within the drive and control component of the
`robotic system.
`The drive and control component of the present invention
`generally includes the drive actuators, e.g., motors, gears or
`pulleys, etc., and positioning devices that are necessary to
`articulate the surgical tool at the surgical site. In addition, the
`drive and control component will usually include the encod-
`ers and electrical connectors required to couple the compo-
`nent to a servomechanism to form a master/slave telerobotic
`surgical system. In a specific configuration of the invention,
`this component comprises a manipulator assembly having a
`drive assembly and a multiple degree of freedom manipu-
`lator arm. The arm and drive assembly are covered by a
`sterile drape to effectively shield these components from the
`sterile surgical field during the operation. In this way, the
`portion of the system including motors, encoders and fragile
`electronics does not have to be sterilized because it
`is
`
`separated from the sterile field surrounding the surgical site.
`The intermediate connector includes a sterile adaptor that
`extends through an opening in the sterile drape to couple the
`sterile surgical tool with the manipulator arm. The adaptor
`includes a plurality of motion and electrical feed-throughs
`for articulating the surgical tool, and for sending electrical
`signals to and from the tool, e.g., force and torque feedback
`signals, etc. In one configuration, the intermediate compo-
`nent includes a scope adaptor for coupling a viewing scope,
`such as an endoscope coupled to a camera mount and a
`camera, to the manipulator arm. In another configuration,
`the intermediate connector includes a surgical instrument
`assembly coupled to the sterile adaptor. The surgical instru-
`ment assembly will usually include a surgical tool, which
`may comprise a variety of articulated tools with end
`effectors, such as jaws, scissors, graspers, needle holders,
`micro dissectors, staple appliers, tackers, suction irrigation
`tools, clip appliers, or non-articulated tools, such as cutting
`blades, cautery probes, irrigators, catheters or suction ori-
`fices.
`
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`6,132,368
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`3
`instrument
`the surgical
`In a preferred configuration,
`assembly will further include a wrist unit for removably
`coupling the surgical tool to the adaptor on the manipulator
`assembly. The wrist unit comprises an elongate shaft with a
`distal wrist coupled to the surgical tool for providing articu-
`lation of the tool about the distal wrist. During a surgical
`procedure,
`the telerobotic system will usually include a
`variety of surgical instrument assemblies, each having a
`wrist unit with a different surgical tool attached. The wrist
`units can be quickly and easily coupled and decoupled from
`the manipulator assemblies to facilitate instrument exchange
`during the procedure. In an exemplary embodiment,
`the
`wrist unit is reposable, and it includes a mechanism for
`counting the number of times the wrist unit is used to inhibit
`further use of the unit.
`
`The manipulator assembly provides a plurality of degrees
`of freedom to the wrist unit and surgical tool including pitch
`and yaw movement of the tool about the wrist, rotation about
`the wrist shaft axis, axial movement and articulation of the
`end effector on the surgical tool. In addition, the manipulator
`assembly preferably provides pitch and yaw motion of the
`wrist unit and the surgical tool about axes perpendicular to
`the wrist shaft. The motors of the drive assembly are located
`proximally from the arm and the intermediate component,
`which facilitates cleaning, decreases the cost of manufac-
`turing the assembly and decreases the inertia of the surgical
`tool and wrist unit. In a preferred configuration, the manipu-
`lator assembly will
`include a remote center positioning
`device, such as a parallelogram linkage, for constraining
`motion of the wrist unit and/or surgical tool about a desired
`fixed center of rotation. This fixed center of rotation may be
`located on the wrist unit shaft, at the distal wrist, or in
`endoscopic procedures, coincident with the entry incision
`within the patient’s body.
`In an exemplary embodiment, the three-component sur-
`gical manipulator of the present
`invention is part of a
`telerobotic system in which the surgeon manipulates input
`control devices and views the operation via a displayed
`image from a location remote from the patient. The system
`includes a servomechanism coupled to one or more manipu-
`lator assemblies to control the wrist units and surgical tools
`in response to the surgeon’s manipulation of the input
`control devices. Position, force, and tactile feedback sensors
`(not shown) may also be employed to transmit position,
`force, and tactile sensations from the surgical tools back to
`the surgeon’s hands as he/she operates the telerobotic sys-
`tem. A monitor is coupled to the viewing scope such that the
`displayed image of the surgical site is provided adjacent the
`surgeon’s hands. The image is preferably oriented so that the
`surgeon feels that he or she is actually looking directly at the
`operating site. This configuration provides the surgeon with
`telepresence, or the perception that the input control devices
`are integral with the surgical tools.
`BRIEF DESCRIPTION OF THE DRAWINGS
`
`FIG. 1 is a schematic view of an operating room, illus-
`trating a telerobotic surgical system and method according
`to the present invention.
`FIG. 2 is an enlarged view of the operating room of FIG.
`1 illustrating a pair of mounting joints coupled to an oper-
`ating table according to the present invention.
`FIG. 3A is a perspective view of a robotic surgical
`manipulator according to the present invention that is par-
`tially covered by a sterile drape.
`FIG. 3B is a perspective view of the robotic surgical
`manipulator without the sterile drape to illustrate a multiple
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`degree of freedom arm coupling a driving assembly with a
`wrist unit and a surgical tool.
`FIG. 4 illustrates the robotic surgical manipulator of
`FIGS. 3A—3B incorporating a camera and endoscope for
`viewing the surgical site.
`FIG. 5 is a partial view of the robotic manipulator of
`FIGS. 3A—3B, illustrating mechanical and electrical cou-
`plings between the arm and the wrist unit.
`FIG. 6 is a partially cut-away sectional view of a forearm
`and a carriage of the manipulator of FIGS. 3a and 3B.
`FIG. 7 is a perspective view of the wrist unit according to
`the present invention.
`FIG. 8 is a side cross-sectional view of a portion of the
`robotic manipulator,
`illustrating the arm and the drive
`assembly.
`DESCRIPTION OF THE PREFERRED
`EMBODIMENT
`
`The present invention provides a multi-component system
`and method for performing robotically-assisted surgical
`procedures on a patient, particularly including open surgical
`procedures, neurosurgical procedures, such as stereotaxy,
`and endoscopic procedures, such as
`laparoscopy,
`arthroscopy,
`thoracoscopy and the like. The system and
`method of the present invention is particularly useful as part
`of a telerobotic surgical system that allows the surgeon to
`manipulate the surgical instruments through a servomecha-
`nism from a remote location from the patient. To that end,
`the manipulator apparatus or slave of the present invention
`will usually be driven by a kinematically-equivalent master
`to form a telepresence system with force reflection. A
`description of a suitable slave-master system can be found in
`co-pending patent application Ser. No. 08/517,053, filed
`Aug. 21, 1995 (Attorney Docket No. 287-004810),
`the
`complete disclosure of which is incorporated herein by
`reference.
`
`Referring to the drawings in detail, wherein like numerals
`indicate like elements, a telerobotic surgical system 2 is
`illustrated according to the present invention. As shown in
`FIG. 1, telerobotic system 2 generally includes one or more
`surgical manipulator assemblies 4 mounted to or near an
`operating table O, and a control assembly 6 for allowing the
`surgeon S to view the surgical site and to control
`the
`manipulator assemblies 4. The system 2 will also include
`one or more viewing scope assemblies 19 and a plurality of
`surgical instrument assemblies 20 adapted for being remov-
`ably coupled to manipulator assemblies 4 (discussed in
`detail below). Telerobotic system 2 usually includes at least
`two manipulator assemblies 4 and preferably three manipu-
`lator assemblies 4. Of course, the exact number of manipu-
`lator assemblies 4 will depend on the surgical procedure and
`the space constraints within the operating room among other
`factors. As discussed in detail below, one of the assemblies
`4 will typically operate a viewing scope assembly 19 (in
`endoscopic procedures) for viewing the surgical site, while
`the other manipulator assemblies 4 operate surgical instru-
`ments 20 for performing various procedures on the patient P.
`Control assembly 6 may be located at a surgeon’s console
`C which is usually located in the same room as operating
`table O so that the surgeon may speak to his/her assistant(s)
`A and directly monitor the operating procedure. However, it
`will be understood that the surgeon S can be located in a
`different room or a completely different building from the
`patient P. Control assembly 6 generally includes a support 8,
`a monitor 10 for displaying an image of the surgical site to
`the surgeon S, and one or more controller(s) 12 for control-
`13
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`6,132,368
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`5
`
`ling manipulator assemblies 4. Controller(s) 12 may include
`a variety of input devices, such as joysticks, gloves, trigger-
`guns, hand-operated controllers, voice recognition devices
`or the like. Preferably, controller(s) 12 will be provided with
`the same degrees of freedom as the associated surgical
`instrument assemblies 20 to provide the surgeon with
`telepresence, or the perception that the controller(s) 12 are
`integral with the instruments 20 so that the surgeon has a
`strong sense of directly controlling instruments 20. Position,
`force, and tactile feedback sensors (not shown) may also be
`employed on instrument assemblies 20 to transmit position,
`force, and tactile sensations from the surgical instrument
`back to the surgeon’s hands as he/she operates the telero-
`botic system. One suitable system and method for providing
`telepresence to the operator is described in co-pending
`patent application Ser. No. 08/517,053, filed Aug. 21, 1995,
`(Attorney Docket No. 02878-004810), which has previously
`been incorporated herein by reference.
`Monitor 10 will be suitably coupled to the viewing scope
`assembly 19 such that an image of the surgical site is
`provided adjacent the surgeon’s hands on surgeon console 6.
`Preferably, monitor 10 will display an inverted image on a
`display 18 that is oriented so that the surgeon feels that he
`or she is actually looking directly down onto the operating
`site. To that end, an image of the surgical instruments 20
`appears to be located substantially where the operator’s
`hands are located even though the observation points (i.e.,
`the endoscope or viewing camera) may not be from the point
`of view of the image. In addition, the real-time image is
`preferably transformed into a perspective image such that
`the operator can manipulate the end effector and the hand
`control as if viewing the workspace in substantially true
`presence. By true presence, it is meant that the presentation
`of an image is a true perspective image simulating the
`viewpoint of an operator that is physically manipulating the
`surgical
`instruments 20. Thus, a controller (not shown)
`transforms the coordinates of the surgical instruments 20 to
`a perceived position so that the perspective image is the
`image that one would see if the camera or endoscope was
`located directly behind the surgical instruments 20. A suit-
`able coordinate transformation system for providing this
`virtual image is described in patent application Ser. No.
`08/239,086,
`filed May 5, 1994,
`(Attorney Docket No.
`02878-003300), the complete disclosure of which is incor-
`porated herein by reference.
`As shown in FIG. 1, a servomechanism 16 is provided for
`transferring the mechanical motion of controllers 12 to
`manipulator assemblies 4. Servomechanism 16 may be
`separate from, or integral with manipulator assemblies 4.
`Servomechanism 16 will usually provide force and torque
`feedback from the surgical
`instruments 20 to the hand-
`operated controllers 12. In addition, servomechanism 16 will
`include a safety monitoring controller (not shown) that may
`freeze or at least inhibit all robot motion in response to
`recognized conditions (e.g., exertion of excessive force on
`the patient, “running away” of the manipulator assemblies 4,
`etc.). The servomechanism preferably has a servo bandwidth
`with a 3 dB cut off frequency of at least 10 hz so that the
`system can quickly and accurately respond to the rapid hand
`motions used by the surgeon. To operate effectively with this
`system, manipulator assemblies 4 have a relatively low
`inertia and the drive motors 170 (see FIG. 8) have relatively
`low ratio gear or pulley couplings. Any suitable conven-
`tional or specialized servomechanism may be used in the
`practice of the present invention, with those incorporating
`force and torque feedback being particularly preferred for
`telepresence operation of the system.
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`6
`Referring to FIG. 7, surgical instrument assemblies 20
`each include a wrist unit 22 and a surgical tool 24 removably
`attached to wrist unit 22. As discussed in detail below, each
`wrist unit 22 generally includes an elongate shaft 56 having
`a proximal cap 58 and a distal wrist 60 pivotally coupled to
`surgical tool 24. Each wrist unit 22 is substantially the same,
`and will have different or the same surgical tools 24 attached
`thereto, depending on the requirements of the surgical
`procedure. Alternatively, wrist units 22 may have special-
`ized wrists 60 designed for individual surgical tools 24 so
`that the wrist units 22 may be used with conventional tools
`24. As shown in FIG. 1, the instrument assemblies 20 are
`usually assembled onto a table T or other suitable support
`adjacent the operating table 0. According to a method of the
`present invention (described below), wrist units 22 and their
`associated surgical tools 24 can be quickly exchanged dur-
`ing the surgical procedure by coupling and decoupling wrist
`unit shafts 56 from manipulator assemblies 4.
`Referring to FIG. 2, each manipulator assembly 4 is
`preferably mounted to operating table 0 by a mounting joint
`30. Mounting joints 30 provide a number of degrees of
`freedom (preferably at least 5) to assemblies 4, and they
`include a brake (not shown) so that assemblies 4 can be fixed
`at a suitable position and orientation relative to the patient.
`Joints 30 are mounted to a receptacle 32 for mounting joints
`30 to operating table 0, and for connecting each manipulator
`assembly 4 to servomechanism 16. In addition, receptacle 32
`may connect joints 30 to other systems, such as an RF
`electrical power source, a suction-irrigation system, etc.
`Receptacle 32 includes a mounting arm 34 that is slidably
`disposed along an outer rail 36 of operating table 0. Of
`course, manipulator assemblies 4 may be positioned over the
`operating table 0 with other mechanisms. For example, the
`system may incorporate a support system (coupled to the
`ceiling or a wall of the operating room) that moves and holds
`one or more manipulator assemblies 4 over the patient.
`Referring now to FIGS. 3—8, manipulator assembly 4 will
`be described in further detail. Manipulator assembly 4 is a
`three-component apparatus that includes a non-sterile drive
`and control component, a sterilizable end effector or surgical
`tool (i.e., surgical instrument assembly 20) and an interme-
`diate connector component. The intermediate connector
`includes mechanical elements for coupling the surgical tool
`24 with the drive and control component, and for transfer-
`ring motion from the drive component to the surgical tool
`24. As shown in FIG. 3B, the drive and control component
`generally includes a drive assembly 40 and a multiple degree
`of freedom robotic arm 42 coupled to a mounting bracket 44,
`which is adapted for mounting onto mounting joints 30
`(FIG. 2). Preferably, drive assembly 40 and robotic arm 42
`are pivotally coupled to bracket 44 about an X-axis, which
`extends through a remote center of spherical rotation 45 (see
`FIG. 8, discussed in further detail below). Manipulator
`assembly 4 further includes a forearm assembly 46 fixed to
`a distal end 48 of arm 42, and a wrist unit adaptor 52 coupled
`to forearm assembly 46 for mounting wrist unit 22 and
`surgical tool 24 to manipulator assembly 4.
`For endoscopic procedures, manipulator assembly 4 addi-
`tionally includes a cannula adaptor 64 attached to a lower
`portion of forearm 46 for mounting a cannula 66 to manipu-
`lator assembly 4. Alternatively, cannula 66 may be an
`integral cannula (not shown) that
`is built
`into forearm
`assembly 46 (i.e., non-removable). Cannula 66 may include
`a force sensing element (not shown), such as a strain gauge
`or force-sensing resistor, mounted to an annular bearing
`within cannula 66. The force sensing bearing supports
`surgical tool 24 during surgery, allowing the tool to rotate
`14
`
`14
`
`

`

`6,132,368
`
`7
`and move axially through the central bore of the bearing. In
`addition, the bearing transmits lateral forces exerted by the
`surgical
`tool 24 to the force sensing element, which is
`connected to servomechanism 16 for transmitting these
`forces to controller(s) 12. In this manner, forces acting on
`surgical tools 24 can be detected without disturbances from
`forces acting on cannula 66, such as the tissue surrounding
`the surgical incision, or by gravity and inertial forces acting
`on manipulator assembly 4. This facilitates the use of
`manipulator assembly in a robotic system because the sur-
`geon will directly sense the forces acting against the surgical
`tool 24.
`
`As shown in FIG. 3A, manipulator assembly 4 further
`includes a sterile drape 70 sized to cover substantially the
`entire manipulator assembly 4. Drape 70 has a pair of holes
`72, 74 sized and arranged so that wrist unit adaptor 52 and
`cannula adaptor 64 may extend through holes 72, 74 to
`mount wrist unit 22 and cannula 66 to manipulator assembly
`4. Sterile drape 70 comprises a material configured to
`effectively shield manipulator assembly 4 from the surgical
`site so that most of the components of assembly 4 (i.e., arm
`42, drive assembly 40 and forearm assembly 46) do not have
`to be sterilized prior to, or following the surgical procedure.
`As shown in FIG. 3A, wrist unit adaptor 52 and cannula
`adaptor 64 extend through holes 72, 74 of drape 70 so that
`forearm assembly 46 and the remainder of manipulator
`assembly 4 remain shielded from the patient during the
`procedure. Wrist unit adaptor 52 and cannula adaptor 64 are
`preferably manufactured as reusable components that will be
`sterilized because these components extend into the sterile
`field of the surgical site. Wrist unit and cannula adapters 52,
`64 may be sterilized by normal methods, i.e., steam, heat and
`pressure, chemicals and the like. Referring again to FIG. 3B,
`wrist unit adaptor 52 includes an opening 80 for receiving
`shaft 56 of wrist unit 22. As discussed in detail below, shaft
`56 can be laterally urged through opening 80 and snap-fit
`into adaptor 52 such that the non-exposed portion of wrist
`unit adaptor 52 remains sterile (i.e., remains on the sterile
`side of drape 70 opposite the sterile field). Wrist unit adaptor
`52 may also include a latch (not shown) for securing wrist
`unit 22 therein. Similarly, cannula adaptor 64 includes an
`opening 82 for snap fitting cannula 66 thereto such that the
`non-exposed portion of adaptor 64 remains sterile during the
`surgical procedure.
`As shown in FIG. 4, wrist unit adaptor 52 may also be
`configured to receive a viewing scope 100 for viewing the
`surgical site. For endoscopic procedures, viewing scope 100
`can be a conventional endoscope, which typically includes
`a rigid, elongated tube 102 containing a lens system (not
`shown) and a camera mount 104 at the proximal end of the
`tube 102. Asmall video camera 106 is preferably attached to
`the camera mount 104 and connected to video monitor 10 to
`
`the
`provide a video image of the procedure. Preferably,
`scope 100 has a distal end (not shown) configured to allow
`lateral or angled viewing relative to tube 102. The viewing
`scope may also have a guidable tip that can be deflected or
`rotated by manipulating an actuator on a proximal end of
`tube 102. This type of scope is commercially available from
`Baxter Healthcare Corp. of Deerfield, 111., or Origin
`Medsystems, Inc. of Menlo Park, Calif.
`As shown in FIG. 4, viewing scope 100 further includes
`a scope adaptor 110 for coupling viewing scope 100 to wrist
`unit adaptor 52. Scope adaptor 110 is sterilizable, ETO and
`autoclavable, and it includes a plurality of motion feed-
`throughs (not shown) for transferring motion from drive
`assembly 40 to scope 100. In the preferred configuration, the
`motion includes pitch and yaw motion, rotation about the
`Z-axis, and movement along the Z-axis.
`
`10
`
`15
`
`20
`
`25
`
`30
`
`35
`
`40
`
`45
`
`50
`
`55
`
`60
`
`65
`
`8
`Referring now to FIGS. 5 and 6, forearm assembly 46 will
`be described in further detail. As shown in FIG. 5, forearm
`assembly 46 includes a housing 120 fixed to arm 42 and a
`movable carriage 122 slidably coupled to housing 120.
`Carriage 122 slidably mounts wrist unit adaptor 52 to
`housing 120 for moving wrist unit adaptor 52 and wrist unit
`20 in the Z-direction. In addition, carriage 122 defines a
`number of openings 123 for transferring motion and elec-
`trical signals from forearm assembly 46 to wrist unit adaptor
`52. As shown in FIG. 6, a plurality of rotatable shafts 124 are
`mounted within housing 120 for transferring motion from
`arm 42 through openings 123 to wrist unit adaptor 52 and
`wrist unit 22. Rotating shafts 124 preferably provide at least
`four degrees of freedom to wrist unit 22, including yaw and
`pitch motion of surgical tool 62 about wrist 60 of wrist unit
`22, rotation of wrist unit 22 about the Z-axis and actuation
`of tool 62. Of course,
`the system may be configured to
`provide more or less degrees of freedom, if desired. Actua-
`tion of tool 62 may include a variety of motions, such as
`opening and closing jaws, graspers or scissors, applying
`clips or staples and the like. Motion of wrist unit 22 and tool
`62 in the Z direction is provided by a pair of carriage cable
`drives 126 extending between rotatable pulleys 128, 129 on
`either end of forearm housing 120. Cable drives 126 func-
`tion to move carriage 122 and wrist unit 22 in the Z direction
`relative to forearm housing 120.
`As shown in FIG. 6, distal end 48 of arm 42 includes a
`coupling assembly 130 having a plurality of motion feed-
`throughs 132 for transferring